Gregg Zaun

Shoulder surgeries among professional baseball players are about as common as foul balls but they don’t always end careers. Zaun injured his shoulder in April when he collided on a plate, but opted to play through the pain. Last month in Pittsburgh, Zaun aggravated the injury while batting. The surgery will repair a torn labrum.

Labrum repair surgeries are not uncommon and can often return players to the field after rehabilitation. But not all patients have been as lucky. Last Fall, the Food and Drug Administration (FDA) issued a warning to health care professionals that during such surgeries, pain pumps should not be used.

Pain pumps are balloon-like devices that are filled with anesthetics and rest outside the body. In many instances, a catheter is placed inside the cartilage at the surgical site, where it drips medication for up to 72 hours. This use has never been approved by the FDA, but pain pump manufacturers instructed surgeons to use them in this manner. As a result, numerous people who had shoulder repair surgeries began complaining of stiffness, a decreased range of motion, and pain. Doctors found that the cartilage in these patients’ shoulders had worn away, causing bone to rub against bone. This painful, debilitating and irreversible condition is known as chondrolysis.

Source: The Canadian Press

SOURCE: Pain Pumps › Zaun to undergo season-ending shoulder surgery

Arthritis in the shoulder is somewhat uncommon, with about 40,000 shoulder replacements being performed each year in the United States. By comparison, 450,000 knee and 230,000 hip replacements are performed annually. But the increasing reports of shoulder arthritis in young patients is alarming on many levels.

For starters, current shoulder replacement techniques do not adequately address the high function demands of young active patients. And while shoulder replacement may help relieve pain, many of these young patients who have shoulder replacement surgery will require further shoulder reconstructive surgery in the future.

The arthritic condition many of these young people suffer with is known as chondrolysis, a condition in which the cartilage in the shoulder joint wears away causing bone to rub against bone. There is no cure, and those who have chondrolysis often suffer from pain, limited mobility and debilitation. In many cases patients require shoulder replacement surgery.

As more and more reports of chondrolysis were being reported in patients following shoulder surgery, surgeons and researchers began to ask why. Laboratory data and clinical reports began pointing to the same likely culprit – the prolonged use of intra-articular local anesthetics administered directly into the shoulder joint by a pain pump device. Investigations found that this was not an FDA-approved use for the pain pump or the anesthetic; however, that didn’t stop pain pump manufacturers from instructing surgeons to use the device in such a way.

Surgeons are now understanding how they have been misled by the makers of pain pumps and with luck, the number of new chondrolysis reports will decrease in time. Until then, the only recourse victims have is to go after the pain pump manufacturers in court.

Source: Gerson Lehrman Group

SOURCE: Pain Pumps › Reports of young patients with arthritis in shoulder increasing

Shoulder injuries are not uncommon among athletes. Hard and repetitive throwing motions like those needed for football and baseball leave many players with shoulder problems, many of which require surgery. While a full recovery is usually possible, some patients’ injuries were worsened by shoulder surgery.

The phenomenon even confused doctors who performed the shoulder repair surgeries. They were finding a growing number of patients months or years after surgery were back in their offices complaining of pain, stiffness and loss of motion. Upon further inspection, doctors found those patients had developed a condition known as chondrolysis, caused by the breakdown of cartilage. As the cartilage wears away, bone begins to rub against bone causing even more pain and damage.

What doctors finally deduced was that it wasn’t the surgery that was causing this specific type of chondrolysis known as postarthroscopic glenohumeral chondrolysis (PAGCL), but the pain pump used during and after surgery. The pain pumps are devices that have a balloon filled with pain-deadening medication. That medication is fed directly into the wound site through a catheter for up to 72 hours.

The pumps were approved by the Food and Drug Administration (FDA) with the catheter placed in the shoulder tissue. But pain pump manufacturers began telling doctors to place the catheters in the shoulder joint, which allowed the joint space to be bathed in medication. What doctors didn’t realize is that constant drip of medication into the shoulder joint was slowly eating away at the cartilage, resulting in chondrolysis.

Since this discovery, published in a recent issue of The American Journal of Sports Medicine, patients who have suffered serious disability from the wrongful use of pain pumps have sued the manufacturers of pain pumps. If you are experiencing the symptoms associated with chondrolysis or PAGCL, you too may have a claim against the manufacturer.

Source: St. Petersburg Times

SOURCE: Pain Pumps › FSU quarterback faces shoulder repair surgery

Some rotator cuff disorders – especially the early stages of rotator cuff damage –  may be treated without surgery through rest and rehabilitation, ice and heat applications, anti-inflammatory medications, and physical therapy. Situations that may require surgery include symptoms that persist for more than 6 months, injuries that occurred suddenly, or if the tear is causing weakness.

Such injuries that may require surgery are those from a major sports injury or auto accident. Very large rotator cuff tears – larger than 2 inches – and tears that affect more than one of the four rotator cuff tendons sometimes cannot be repaired. But surgery may be able to relieve pain by removing damaged tissue from the joint.

Surgery, however, cannot always completely resolve problems with regular wear-and-tear over the years. And whether you choose to have surgery or not, rehabilitation and physical therapy will be required to get your shoulder back to near-par.

Surgery risks include infection, persistent pain, slow healing followed by stiffness, and the potential need for more surgery. In some cases, surgery may cause irregular heat rhythms, changes in blood pressure and heart attack.

Patients who have had shoulder surgery in the past have also suffered from a condition in which the cartilage has worn away, called chondrolysis. This condition was found to have been caused by a pain pump device that was implanted in patients following surgery to help relieve pain for up to 72 hours following surgery. If you have had shoulder surgery and are still experiencing pain and limited mobility, or have been diagnosed with chondrolysis, you may have a claim against the manufacturer.

SOURCE: Pain Pumps › Weigh pros, cons of shoulder surgery

Pain pumps

The devices take the place of narcotics, which carry a laundry list of side effects from nausea to vomiting to constipation and decreased sleep. They also require more monitoring and may require the patient to have a longer stay in the hospital.

“It may be $2,000 a day to have a patient stay in the hospital, so in this era of trying to reduce health care costs, if we can reduce their hospitalization from three days to one – or even better, to discharge them on the day of the surgery as an outpatient – we’ve dramatically changed the cost of that shoulder replacement or other major surgery,” said Randall Malchow, director of the Regional Anesthesia and Acute Pain Fellowship at Vanderbilt University. Dr. Malchow discussed the benefits of pain pumps for ABC 7 News.

The biggest risk these days with shoulder pain pumps is that in some cases, the pump does not work. That requires the patient to be admitted to the hospital and have pain medications administered by doctors and nurses. There is also a slight risk – about 1 percent – of infection. Pain pumps can be used for shoulder, elbow, wrist, knee and hip replacements.

The risks have recently improved since doctors began to make a connection between an alternative use of pain pumps and a painful and debilitating condition known as chondrolysis. Chondrolysis is when the cartilage in the joint has worn away and bone begins to rub against bone.

For years in the late 1990s and early 2000s, manufacturers of pain pumps began telling doctors to implant the pumps’ catheters directly into the shoulder joint rather than into the shoulder tissue. Inserting the catheter into the shoulder joint was not an FDA-approved use, as was placing the catheter in the shoulder tissue. By placing the catheters into the joint space, the medication dripped directly onto the cartilage and began eating away at it. The result? Pain, loss of motion, and limited use of the shoulder.

Today, doctors are using pain pumps as the FDA had intended – with the catheters placed in the shoulder tissue, with few risks. However, many of those who suffered because the pain pump manufacturers gave the surgeons ill advice have slapped the manufacturers with hundreds of lawsuits seeking justice.

SOURCE: Pain Pumps › Pain pumps less risky these days

The pain pumps eliminate the need for narcotics and costly hospital stays, and revolutionized pain management for procedures such as shoulder surgery. However, pain pumps didn’t always prove to be the best solution.

The pain pumps were first approved by the Food and Drug Administration (FDA) with the catheters feeding into the shoulder tissue. However, in the 1990s, the manufacturers of pain pumps asked the FDA to approve an alternative use – placing the catheters directly into the shoulder joint. The FDA required more testing before it would approve such a use. Rather than following proper protocol and running tests on the alternative use, the device manufacturers began advising surgeons to place the catheters in the shoulder joint.

Months and years later, doctors began noticing patients who had had shoulder surgery were beginning to suffer from a serious and debilitating condition known as chondrolysis in which the cartilage in the joint is worn away. Those doctors began to make the connection between patients with chondrolysis and the alternative use of the pain pumps.

Today, manufacturers of pain pumps are facing hundreds of lawsuits from people who have been injured by the devices. If you or a loved one has had shoulder surgery and now suffer from pain, weakness in the shoulder, decreased range of motion in the shoulder, or weakness in the shoulder, you may have a claim against the manufacturer.

Source: WCTV-TV

SOURCE: Pain Pumps › Shoulder pain pump makers face numerous lawsuits

Intra-articular pain pumps

Intra-articular pain pumps are medical devices that hold pain medication. The devices have a tube with a catheter attached to them and that catheter is approved by the Food and Drug Administration (FDA) to be placed in the shoulder tissue for pain relief. The catheter is sort of like a garden hose with holes in it that you place in a flowerbed. Just as water would pass through the garden hose to water plants in the bed, medication is pumped through the catheter of the pain pumps into the shoulder tissue gradually over a 48- to 73-hour period. Once the pain medication has been completely used, the patient is instructed to simply pull the catheter out of his shoulder.

Before pain pumps became available for use, patients were given medication either orally or by injection and would have to be monitored by medical staff. The use of pain pumps allowed patients to go home earlier and require less medical attention post surgery. Used properly, risks associated with pain pumps are minimal and most patients have a relatively good recovery after physical therapy. But then tragedy struck.

“With advice from manufacturers, the pain pump catheters were being placed in the joint space or intra-articular area (as opposed to the joint tissue, as was approved by the FDA) which allowed the pain medication into the joint space,” says Frank Woodson, shareholder with Beasley Allen Law Firm. As a result, “doctors began to see patients suffer severe damage to their shoulder cartilage that we’ve rarely seen before.”

The condition, called chondrolysis, is the loss of cartilage in the joint space and causes extreme pain, loss of motion and in many cases, shoulder replacement. Those who relied on their shoulder strength, found themselves suffering from career-ending injuries.

Approximately 140 lawsuits against manufacturers of pain pumps are currently filed by individuals injured by those pumps. “As patients and physicians learn more about the link between pain pumps and chrondrolysis, I think you’ll see more people come forward,” Woodson says.

SOURCE: Pain Pumps › Pain pump manufacturers knowingly put patients at risk